Student of Concern Form

AU Cares Student of Concern Form

Use this form to submit student behavior concerns and/or to report an incident. **The CARE Team is not tasked with responding to emergencies. If this is an emergency and you are in need of immediate assistance or consultation, contact Campus Safety at 864-231-2060.
Your full name:*
Your position/title:*
Your phone number:*
Your email address:*
Your physical address:*
Name of Student of Concern*
Student's Gender*
Student's ID Number (if known)
Student's Year
Student's Birth Date (if known)

MonthDayYear
Student's Phone Number (if known)
Student's Email Address (if known)
Student's Residence Hall Assignment (if known)
Is this report a result of a specific incident or occurrence?*

YesNo

Specifics Regarding Incident

If you are submitting this report as the result of a specific incident please provide a details to enable the best follow up.
Choose the date and time of this incident*

MonthDayYearHourMinutesAM/PM Option
Specific location of the incident:*
Please provide a detailed description of the incident using specific concise, objective language.*

AU Cares Student of Concern Form